Acute respiratory tract infection (ARI) is a leading cause of morbidity and mortality throughout the world. Although an estimated 20% of global childhood deaths due to respiratory infection occur in India, the relative contribution of respiratory viruses and bacterial pathogens to acute respiratory infection in India is not well defined. Quantifying and characterizing the disease burden due to influenza and other bacterial and viral causes of respiratory disease such as influenza and respiratory syncytial virus (RSV) will help to target disease prevention and treatment strategies such as vaccination for respiratory disease, including Influenza. Through testing for a panel of respiratory pathogens including influenza, the clinical spectrum and severity of illness attributable to influenza and the relative contribution of individual pathogens and co-infection with multiple pathogens can be characterized and new or re-emerging respiratory pathogens of potential global importance can be detected. Higher rates of respiratory infectious diseases in India provide an opportunity to learn more about the epidemiology and preventability of respiratory infectious diseases of emerging importance globally. Ability to establish multiple field sites and active weekly surveillance systems and collection of respiratory specimens from both rural and urban setting in India, and provide molecular testing for multiple pathogens in timely fashion will be critical to success of the study.